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A family history of fracture and fracture risk: a meta-analysis

Kanis, JA; Johansson, H; Oden, A; Johnell, Olof LU ; De Laet, C; Eisman, JA; McCloskey, EV; Mellstrom, D; Melton, LJ and Pols, HAP, et al. (2004) In Bone 35(5). p.1029-1037
Abstract
The aims of the present study were to determine whether a parental history of any fracture or hip fracture specifically are significant risk factors for future fracture in an international setting, and to explore the effects of age, sex and bone mineral density (BMD) on this risk. We studied 34,928 men and women from seven prospectively studied cohorts followed for 134,374 person-years. The cohorts comprised the EPOS/EVOS study, CaMos, the Rotterdam Study, DOES and cohorts at Sheffield, Rochester and Gothenburg. The effect of family history of osteoporotic fracture or of hip fracture in first-degree relatives, BMD and age on all clinical fracture, osteoporotic fracture and hip fracture risk alone was examined using Poisson regression in... (More)
The aims of the present study were to determine whether a parental history of any fracture or hip fracture specifically are significant risk factors for future fracture in an international setting, and to explore the effects of age, sex and bone mineral density (BMD) on this risk. We studied 34,928 men and women from seven prospectively studied cohorts followed for 134,374 person-years. The cohorts comprised the EPOS/EVOS study, CaMos, the Rotterdam Study, DOES and cohorts at Sheffield, Rochester and Gothenburg. The effect of family history of osteoporotic fracture or of hip fracture in first-degree relatives, BMD and age on all clinical fracture, osteoporotic fracture and hip fracture risk alone was examined using Poisson regression in each cohort and for each sex. The results of the different studies were merged from the weighted beta coefficients. A parental history of fracture was associated with a modest but significantly increased risk of any fracture, osteoporotic fracture and hip fracture in men and women combined. The risk ratio (RR) for any fracture was 1.17 (95% CI = 1.07-1.28), for any osteoporotic fracture was 1.18 (95% CI = 1.06-1.31), and for hip fracture was 1.49 (95% CI = 1.17-1.89). The risk ratio was higher at younger ages but not significantly so. No significant difference in risk was seen between men and women with a parental history for any fracture (RR = 1.17 and 1.17, respectively) or for an osteoporotic fracture (RR = 1.17 and 1.18, respectively). For hip fracture, the risk ratios were somewhat higher, but not significantly higher, in men than in women (RR = 2.02 and 1.38, respectively). A family history of hip fracture in parents was associated with a significant risk both of all osteoporotic fracture (RR 1.54; 95 CI = 1.25-1.88) and of hip fracture (RR = 2.27; 95% CI 1.47-3.49). The risk was not significantly changed when BMD was added to the model. We conclude that a parental history of fracture (particularly a family history of hip fracture) confers an increased risk of fracture that is independent of BMD. Its identification on an international basis supports the use of this risk factor in case-finding strategies. (C) 2004 Elsevier Inc. All rights reserved. (Less)
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Contribution to journal
publication status
published
subject
keywords
hip fracture, family history, meta-analysis, osteoporotic fracture
in
Bone
volume
35
issue
5
pages
1029 - 1037
publisher
Elsevier
external identifiers
  • pmid:15542027
  • wos:000225376900004
  • scopus:8444247855
ISSN
1873-2763
DOI
10.1016/j.bone.2004.06.017
language
English
LU publication?
yes
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d787f2ba-f7df-49b7-8a6d-c785a31cde68 (old id 897843)
date added to LUP
2008-01-15 12:14:53
date last changed
2017-10-22 04:42:47
@article{d787f2ba-f7df-49b7-8a6d-c785a31cde68,
  abstract     = {The aims of the present study were to determine whether a parental history of any fracture or hip fracture specifically are significant risk factors for future fracture in an international setting, and to explore the effects of age, sex and bone mineral density (BMD) on this risk. We studied 34,928 men and women from seven prospectively studied cohorts followed for 134,374 person-years. The cohorts comprised the EPOS/EVOS study, CaMos, the Rotterdam Study, DOES and cohorts at Sheffield, Rochester and Gothenburg. The effect of family history of osteoporotic fracture or of hip fracture in first-degree relatives, BMD and age on all clinical fracture, osteoporotic fracture and hip fracture risk alone was examined using Poisson regression in each cohort and for each sex. The results of the different studies were merged from the weighted beta coefficients. A parental history of fracture was associated with a modest but significantly increased risk of any fracture, osteoporotic fracture and hip fracture in men and women combined. The risk ratio (RR) for any fracture was 1.17 (95% CI = 1.07-1.28), for any osteoporotic fracture was 1.18 (95% CI = 1.06-1.31), and for hip fracture was 1.49 (95% CI = 1.17-1.89). The risk ratio was higher at younger ages but not significantly so. No significant difference in risk was seen between men and women with a parental history for any fracture (RR = 1.17 and 1.17, respectively) or for an osteoporotic fracture (RR = 1.17 and 1.18, respectively). For hip fracture, the risk ratios were somewhat higher, but not significantly higher, in men than in women (RR = 2.02 and 1.38, respectively). A family history of hip fracture in parents was associated with a significant risk both of all osteoporotic fracture (RR 1.54; 95 CI = 1.25-1.88) and of hip fracture (RR = 2.27; 95% CI 1.47-3.49). The risk was not significantly changed when BMD was added to the model. We conclude that a parental history of fracture (particularly a family history of hip fracture) confers an increased risk of fracture that is independent of BMD. Its identification on an international basis supports the use of this risk factor in case-finding strategies. (C) 2004 Elsevier Inc. All rights reserved.},
  author       = {Kanis, JA and Johansson, H and Oden, A and Johnell, Olof and De Laet, C and Eisman, JA and McCloskey, EV and Mellstrom, D and Melton, LJ and Pols, HAP and Reeve, J and Silman, AJ and Tenenhouse, A},
  issn         = {1873-2763},
  keyword      = {hip fracture,family history,meta-analysis,osteoporotic fracture},
  language     = {eng},
  number       = {5},
  pages        = {1029--1037},
  publisher    = {Elsevier},
  series       = {Bone},
  title        = {A family history of fracture and fracture risk: a meta-analysis},
  url          = {http://dx.doi.org/10.1016/j.bone.2004.06.017},
  volume       = {35},
  year         = {2004},
}